It is known and accepted practice to insert a cuffed tracheotomy tube into a patient's windpipe through a surgical opening in the neck in order to connect the patient to a ventilator. Upon insertion the cuff, which in effect is a collapsible, closed annular chamber about the end of the tube, is inflated whereby to provide a substantially airtight seal between the tube and the wall of the windpipe. This ensures that incoming air from the ventilator on leaving the tube passes into the lungs and cannot escape and leak away about the exterior of the tube.
Such a known tube is effective but suffers from the disadvantage in that once inserted in position it is impossible for the patient to ventilate himself in the normal, natural manner through the nose and mouth. Usually a patient will be encouraged to leave the ventilator in a progressive manner. Thus the patient will be encouraged to ventilate himself spontaneously for progressively increasing time intervals. This necessitates the removal of the tube to allow the patient to breathe through the mouth and nose and the reinsertion of the tube for reconnection to the ventilator. The repeated removal and reinsertion of the tube can be an uncomfortable and distressing experience for the patient.
The present invention seeks to provide a tracheotomy tube which does not require to be withdrawn to enable a patient to ventilate himself in a normal, natural manner spontaneously through the nose and mouth. According to the present invention there is provided a tracheotomy tube having a cuffed end with an aperture or opening in the wall of the tube intermediate its ends and means slidably cooperable with the wall of the tube to selectively open and close the aperture or opening therein, said means being such as to provide a minimum change in the bore of the tube.
Conveniently, the tube can be provided with first and second removable inserts. The first insert is adapted to sealingly close the aperture when a patient is connected to a ventilator. The second insert is adapted to expose the aperture while providing a support for the wall of the tube in the region of the aperture when the patient is ventilating himself in a normal, natural manner.